Partnership Liaison Officer, Prevention & Cancer Control, Ontario Health (Cancer Care Ontario), Toronto, ON.
Lead Scientist, ColonCancerCheck Program, Ontario Health (Cancer Care Ontario), Toronto, ON, Scientist and Staff Gastroenterologist, Sunnybrook Health Sciences, Toronto, ON.
Healthc Policy. 2020 Feb;15(3):28-46. doi: 10.12927/hcpol.2020.26132.
First Nations peoples in Ontario are facing increasing rates of cancer and have been found to have poorer survival. Cancer screening is an important strategy to improve cancer outcomes; yet, Indigenous people in Canada are less likely to participate in screening. Ontario has established organized breast, cervical and colorectal cancer screening programs; this paper examines the health policy context that informs these programs for First Nations peoples in the province.
This paper follows an embedded multiple-case study design, drawing upon a document review to outline the existing policy context and on key informant interviews to explore the aforementioned context from the perspective of stakeholders.
Policies created by agencies operating across federal, regional and provincial levels impact First Nations peoples' access to screening. Interviews identified issues of jurisdictional ambiguity, appropriateness of program design for First Nations persons and lack of cultural competency as barriers to participation in screening.
Federal, provincial and regional policy makers must work in collaboration with First Nations peoples to overcome barriers to cancer screening created and sustained by existing policies.
安大略省的第一民族人民面临着癌症发病率不断上升的问题，并且发现他们的生存率较低。癌症筛查是改善癌症结果的重要策略；然而，加拿大的原住民参与筛查的可能性较低。安大略省已经建立了有组织的乳腺癌、宫颈癌和结直肠癌筛查计划；本文研究了为该省的第一民族人民制定这些计划的健康政策背景。
本文采用嵌入式多案例研究设计，通过文献回顾概述现有政策背景，并通过关键知情人访谈从利益相关者的角度探讨上述背景。
在联邦、地区和省级各级运作的机构制定的政策影响了第一民族人民获得筛查的机会。访谈确定了管辖权不明确、计划设计对第一民族人士的适宜性以及缺乏文化能力等问题，这些问题是参与筛查的障碍。
联邦、省级和地区政策制定者必须与第一民族人民合作，克服由现有政策造成和维持的癌症筛查障碍。
